Nolte: One of their collection loc's: 50% of samples had pertussis. Visited, contamination at point of coll #AMP2017
10:48am November 17th 2017 via Hootsuite
Nolte: POCT operators not familiar with NAATs. Glove changes? Bleach? Pseudo-outbreaks of pertussis from FPs NATs #AMP2017
10:47am November 17th 2017 via Hootsuite
Nolte: Shows real-life desk. Crowded. Buckets, biohazard cans, janitor broom. What could go wrong? #AMP2017
Nolte: They use GenMark FilmArray, 7200 tests, $900K annual cost. Discusses 'point of service' vs 'care' options #AMP2017
10:46am November 17th 2017 via Hootsuite
Nolte: Est cost savings of $200/case. Ped pts with GenMark '17 ref survey https://t.co/fkgq0VaA7J 64% considered mgmt change #AMP2017
10:43am November 17th 2017 via Hootsuite
Nolte: Emer Dept pts, 289 Liat tested. Hansen of Univ Minn: documented changes in mgmt in 67% of cases #AMP2017
10:41am November 17th 2017 via Hootsuite
Nolte: No fee-for-service in many loc's (cost vs reimb). Silo'd budgets, no robust clin outcome or health-care econ. data #AMP2017
10:39am November 17th 2017 via Hootsuite
Nolte: "Is the juice worth the squeeze?" Sens inc 20%. May divert up to 20% of in-lab comprehensive resp panel orders #AMP2017
10:38am November 17th 2017 via Hootsuite
Nolte: Reimb $115.92 for A/B, $174.76 A/B&RSV, $47.80 GAS. 410% incr in costs. #AMP2017
10:37am November 17th 2017 via Hootsuite
Nolte: $120K for old tests. For Liat: same volumes, INF A/B cost $37.87, A/B & RSV $45.88; GAS $23.87 #AMP2017
10:36am November 17th 2017 via Hootsuite
Nolte: Cost and reimb for RADTs: they did 7,790 tests for inf A/B, $98,031 at $16.33. Cost was $12.30 #AMP2017
10:35am November 17th 2017 via Hootsuite
Nolte: Showed fig Ct values by Liat, cp to Alere. Late Cts were Alere FN. #AMP2017
10:34am November 17th 2017 via Hootsuite
Nolte: Liat is ampl plot, no Ct data. Roche permission 'had to be signed by the Pope I think' (!!) #AMP2017
10:33am November 17th 2017 via Hootsuite
Nolte: But Alere was 73%; FilmArray RP was the comparator. Alere reported by others higher #AMP2017
Nolte: Liat: 300uL sample, scan, load. Published '16 side-by-side https://t.co/OPeJLawJA7 Liat performed 100% #AMP2017
10:32am November 17th 2017 via Hootsuite
Nolte: Ease of Alere: many moving parts, 7 steps, 3 min warm-up req'd (not ideal). Liat: simpler #AMP2017
10:31am November 17th 2017 via Hootsuite
Nolte: Onto BioFire Syndromic Panel POCT: 14 viruses, 3 bact, 2 min ho time, 1h analysis #AMP2017
10:30am November 17th 2017 via Hootsuite
Nolte: Alere RALS is agnostic; Liat is HL7 (more trad) #AMP2017
10:29am November 17th 2017 via Hootsuite
Nolte: Both qual results, both nasal swabs, 15m vs 20m time. Alere has sped up to 5 min in newer version #AMP2017
10:28am November 17th 2017 via Hootsuite
Nolte: Shows Alere i cp to Liat: NEAR, mol beacons vs real-time PCR, Taqman. NEAR = nicking isothermal ampl #AMP2017
10:27am November 17th 2017 via Hootsuite
Nolte: Adv for NAATs for infl: no confirm test needed; inc sens dec potential of timing, pt pop, source, collection issues #AMP2017
10:26am November 17th 2017 via Hootsuite
Nolte: iStat is $5-$8, if operator error is high then the costs add up. Connectivity to EMR w/ NAAT 'is a big deal' #AMP2017
10:25am November 17th 2017 via Hootsuite
Nolte: Moderate throughput for NAAT; trad immunoassay are prone to operator error. Less for digital immno; unk for NAAT #AMP2017
10:23am November 17th 2017 via Hootsuite
Nolte: For lateral flow, about 54% sens (var), digital immuno 80%, NAAT 95%. Reimb from $16.33 (Medicare) to NA $115.92 #AMP2017
10:22am November 17th 2017 via Hootsuite
Nolte: #AMP2017 Det assays '17 rev https://t.co/Uh8QUISjb4 80% was the best; 77% for Infl B. For NAAT Infl A 97%; B 95%
10:21am November 17th 2017 via Hootsuite
Nolte: 80% sens for NA, 90% sens for culture. Issued Jan '17. Enforcement Jan '18. Expect fewer but better, choices #AMP2017
10:19am November 17th 2017 via Hootsuite
Nolte: HTN1 in '09: prompted focus, '13 changed from Class I to Class II for rapid antigen test for influenza. #AMP2017
10:18am November 17th 2017 via Hootsuite
Nolte: Case of rapid influenza tests - CDC table https://t.co/oUrV4j09OI RADT - good spec but poor sens. #AMP2017
10:17am November 17th 2017 via Hootsuite
Nolte: #AMP2017 Shows nice review table of POCT from '17 J Clin Micro https://t.co/OYIdd5ToCR
10:14am November 17th 2017 via Hootsuite
Nolte: #AMP2017 Chose figures from this '17 CLP online pub https://t.co/KMkHfVAIHr
10:13am November 17th 2017 via Hootsuite
Nolte: Challenges: dozens of sites, greater than hundreds of instruments, thousands of operators. Connectivity too #AMP2017
10:12am November 17th 2017 via Hootsuite
Nolte: WHO ASSURED: Affordable, Sens, Spec, User-friendly, Rapid, Robust, Equipment-Free, Deliverable #AMP2017
10:11am November 17th 2017 via Hootsuite
Nolte: Shd result 'in clear and actionable mgmt decisions... e.g. when to start trtmt or req confirmation w/in same clin encounter' #AMP2017
10:10am November 17th 2017 via Hootsuite
Nolte: "but I smile b/c people will find a way to do it wrong" Milestone: 2015 of first CLIA-waived NAAT Alere i Influenza A&B Test #AMP
10:09am November 17th 2017 via Hootsuite
Nolte: Def'n of waived: simple to do, little chance that test will provide wrong info or cause harm. #AMP2017
10:08am November 17th 2017 via Hootsuite
Nolte: Near-pt can be at home; POC is CLIA-waived tests. But some know POC are moderately complex, not nec CLIA-waived #AMP2017
Nolte: POC is near-patient, outside the lab, by non-lab personnel. <20 min analysis time. Def'ns vary. #AMP2017
10:07am November 17th 2017 via Hootsuite
Nolte: Will start with general concepts; describe how NA-based detection are disruptive; use infl. and gr A strep as examples #AMP2017
Special Molecular Infectious Disease Session: Frederick Nolte (Med Univ SC) Point of Care: Opportunities and Challenges #AMP2017
10:06am November 17th 2017 via Hootsuite
A2: Druley: MeDIP, other methods are possible but aren't sens enough. Haven't looked at other mods for same reasons #AMP2017
9:47am November 17th 2017 via Hootsuite
Q: Can you look at epigenetics, MSI with MRD? Druley: Problem with harsh bisulfite treatment. Libraries haven't suf… https://t.co/xjuIUlv5XD
9:46am November 17th 2017 via Hootsuite
A4 Druley: Multiplexed ddPCR isn't cheap nor easy; orthogonal platform with same LOD #AMP2017
9:45am November 17th 2017 via Hootsuite
A3 Druley: Tries to start with 500K template molecules / sample. 1:10K you need to have enough molecules to start with #AMP2017
A2 Druley: 8-oxo-guanine due to oxidative damage in extraction, G to T. '15 paper was 1:300 to 1:500 for G to T change #AMP2017
9:44am November 17th 2017 via Hootsuite
Q: For MRD, how consistent over time? Validation for new var's? Druley: The answer is no; expected C to T b/c of deamination #AMP2017
9:43am November 17th 2017 via Hootsuite
A2: Druley: Also rules around read families to ensure fidelity of UMI identifier #AMP2017
9:42am November 17th 2017 via Hootsuite
Q: Errors in the UMI? Druley: Looking at redundancy - errors in the index. Only need 3-7 reads/index. An early 'new… https://t.co/Fy19o4uCij
Druley: Ped AML - 'we've made progress but at a cost - delayed learning and growth'. Credits Illumina, Archer. Inde… https://t.co/4NAeOXrFjk
9:40am November 17th 2017 via Hootsuite
Druley: Goal - build comprehensive 'sequencing toolbox to improve MRD detection and precision drug selection for ped AML' #AMP2017
9:39am November 17th 2017 via Hootsuite
Druley: custom Archer 40 genes, 28kb, also Archer Heme v2. Also w/CHOP - proteomics. Cp against MRD via flow #AMP2017
9:38am November 17th 2017 via Hootsuite
